Inequity in Adoption of Advanced Diabetes Technologies Among Medicare Fee-for-service Beneficiaries

Author:

Wherry Kael1ORCID,Zhu Cyrus1ORCID,Vigersky Robert A1ORCID

Affiliation:

1. Medtronic Diabetes, Northridge, CA 91325, USA

Abstract

Abstract Context Health inequity is often associated with race-ethnicity. Objective To determine the prevalence of insulin pump therapy and continuous glucose monitoring (CGM) among Medicare beneficiaries with type 1 diabetes (T1D) by race-ethnicity, and to compare diabetes-related technology users with nonusers. Design The prevalence of technology use (pump, CGM) was determined by race-ethnicity for enrollees in coverage years (CY) 2017-2019 in the Medicare fee-for-service database. Using CY2019 data, technology users were compared with nonusers by race-ethnicity, sex, average age, Medicare eligibility criteria, and visit to an endocrinologist. Setting Community Patients or Other Participants Beneficiaries with T1D and at least 1 inpatient or 2 outpatient claims in a CY. Intervention(s) Pump or CGM therapy, visit to an endocrinologist. Main Outcome Measure(s) Diabetes-related technology use by race-ethnicity groups. Results Between 2017 and 2019, CGM and insulin pump use increased among all groups. Prevalence of insulin pump use was < 5% for Black and Other beneficiaries yet increased from 14% to 18% among White beneficiaries. In CY2019, 57% of White patients used a pump compared with 33.1% of Black and 30.3% of Other patients (P < 0.001). Black patients were more likely than White patients to be eligible because of disability/end-stage renal disease or to be Medicare/Medicaid eligible (both P < 0.001), whether using technology or not. Significant race-ethnicity differences (P < 0.001) existed between technology users and nonusers for all evaluated factors except visiting an endocrinologist. Conclusions Significant race-ethnicity associated differences existed in T1D management. The gap in diabetic technology adoption between Black and White beneficiaries grew between 2017 and 2019.

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

Reference24 articles.

1. Racial-ethnic disparities in management and outcomes among children with type 1 diabetes;Willi;Pediatrics.,2015

2. State of type 1 diabetes management and outcomes from the T1D exchange in 2016-2018;Foster;Diabetes Technol Ther.,2019

3. A clinical overview of insulin pump therapy for the management of diabetes: past, present, and future of intensive therapy;Berget;Diabetes Spectr.,2019

4. Institute of Medicine committee on understanding and eliminating racial ethnic disparities in health care;Smedley,2003

5. Social determinants of health and diabetes: a scientific review;Hill-Briggs;Diabetes Care.,2020

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3